Maximizing Independence at Home for Clients with Early Stage Dementia
How important to you is your Independence? How important is it to be able to do what you want, when you want to? To most, it means having a full life instead of simply “existing.” Freedom is so important that countries fight wars to protect or take back their freedom, and to have what we now call “independence.”
Older people with dementia, whose activities are controlled and limited, also feel this way. They feel they need fight for the right to accomplish tasks on their own and to decide for themselves. They only want to live their lives the way they used to. They think, “Why not? A little forgetfulness does not make me an invalid.” Their age and experience are evidence of their successful decision-making over the years, which make them an “expert” in many different things. For clients, a “little forgetfulness” does not have to be enough reason to keep them in their homes or in facilities, feeling like children who would endanger themselves without proper supervision.
Caring for a client with early-stage dementia, who fights for their independence, can be a big challenge to caregivers because it often results in power struggles. The caregiver fears that, if they do not put some limitations to a client's freedom, the client's safety and health would be at stake. On the other hand, when a client cannot regain control, they can feel weak, frustrated, angry, and depressed. In both cases, the caregiver is faced with seeing through a difficult situation.
When a client with early-stage dementia demands their independence, caregivers are often left wondering how to best handle the situation. The only solution is to maintain balance by looking for a compromise, where caregiver and client can meet halfway. This solution is called maximizing independence.
What are some of the ways to maximize independence for clients with dementia, so that everyone is happy and confident that the client will be fine on their own at home? Here are some helpful tips for caregivers:
1. BE CLEAR ABOUT WHAT THE CLIENT CAN AND CANNOT DO ON THEIR OWN. If they can eat on their own but should not cook, have prepared meals ready to be warmed or have a service like Meals-on-Wheels deliver food. When caregivers know which activities clients can perform by themselves, it is easier to adapt the home and provide them with the necessary tools to safely live on their own.
2. INSTALL SAFETY FEATURES AT HOME AND REMOVE CLUTTER. Make sure that grab bars are installed in the bathroom and on the toilet, and any other place they are needed. Check if there is a need for a raised toilet seat or a bedside commode. Remove clutter, which can cause falls.
3. KEEP REMINDERS FOR THE CLIENT. Remind them of doctor’s appointments or of their medication times. Perhaps stop by for a hello after lunch to check if they’ve turned off the stove.
4. ORGANIZE AND SIMPLIFY THINGS. Confusion in clients with dementia worsens over time, so it really helps to have things at home organized and simplified. Organizing their one-week’s supply of medications, labeled and color-coded, will help those in early-stage dementia to know which medications are due. When choosing decor for the house, avoid designs that have too many complicated patterns and colors. For example, use only white plates and other dinnerware.
5. HAVE IMPORTANT CONTACT NUMBERS ON SPEED DIAL. Set number 1 on the phone pad to dial the person to contact during an emergency.
6. PRE-ARRANGE APPOINTMENT SCHEDULES AND TRANSPORATION. Some tasks may be too complicated for clients with early-stage dementia, such as appointment-setting and scheduling transportation. Caregivers can help in this regard.
7. MAKE ROOM FOR EXTRA TIME IF THEY LIVE WITH YOU. If they prefer to do things on their own and they will be safe while doing so, giving them enough time to finish a task will help build their confidence and self-esteem. As a caregiver, you will need to remember to have a lot of patience with them.
8. BREAK BIG ACTIVITIES INTO SMALL TASKS WHEN YOU ARE WORKING TOGETHER. If they become confused about setting the table, give step-by-step instructions on how to perform the task, such as “Put the placemat on the table, take two plates out of the dish rack, get two spoons and two forks…” This way, the client will feel good about accomplishing a task and still being able to be helpful.
As caregivers, your empathy toward a client who needs their independence must be the basis of your care. Clients with dementia are elders of our society who deserve your utmost respect, while ensuring their freedom to do the things they can for themselves, within the limits of their health and safety.
